Maternal Stress, Human Milk Composition, and Neurodevelopmental and Feeding Outcomes

母体压力、母乳成分以及神经发育和喂养结果

• 批准号: 10424963
• 负责人: Emily M Nagel
• 金额: $ 12.28万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10424963
• 关键词: Academy; Address; Affect; Age; American; Anxiety; Award; Biological; Birth; Brain; Breast Feeding; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Choline; Clinical; Collection; Community Health; Computerized Medical Record; Data; Development; Documentation; Economic Burden; Electroencephalogram; Electroencephalography; Electrophysiology (science); Environment; Epidemiology; Event-Related Potentials; Fatty Acids; Foundations; Future; Goals; Health; Hospitalization; Human Milk; Hydrocortisone; Immune; Impairment; Incidence; Infant; Intervention; Lactation; Learning; Linear Regressions; Live Birth; Measurement; Measures; Medical; Mental Depression; Metabolic; Metagenomics; Milk; Minnesota; Modeling; Mothers; National Institute of Child Health and Human Development; Neonatal Intensive Care Units; Neurocognitive; Neurodevelopmental Disorder; Nutritional; Oligosaccharides; Outcome; Pathway interactions; Pediatrics; Phase; Physiology; Pregnancy; Premature Birth; Premature Infant; Protocols documentation; Psychosocial Assessment and Care; Psychosocial Stress; Public Health Schools; Recommendation; Records; Research; Salivary; Sampling; Science; Services; Severities; Signal Transduction; Stress; Stressful Event; Supplementation; Techniques; Testing; Time; Training; Triad Acrylic Resin; Tryptophan; Tyrosine; Universities; Variant; Visual Cortex; Visual evoked cortical potential; Vulnerable Populations; Work; auditory stimulus; bacterial community; biological systems; career; career development; cognitive function; disability; donor milk; enhancing factor; evidence base; experience; feeding; improved; maternal stress; metabolome; metabolomics; microbial; microbiome; milk production; multiple omics; neurobehavioral; neurobehavioral disorder; neurodevelopment; novel; nutrition; nutritional supplementation; peer; perceived stress; postnatal; psychosocial; recruit; resilience; response; skills; sociodemographics; stressor; therapy design; tool

PROJECT SUMMARY/ABSTRACT Preterm birth and the hospitalization of infants in the neonatal intensive care unit (NICU) are well-documented as stressful events for mothers. Although maternal milk is critically important to promote optimal health and neurodevelopment for preterm infants, the effects of maternal postnatal stress on maternal lactation and feeding outcomes and milk composition have not been systematically examined. The goal of this proposed Pathway to Independence Award is to pair a detailed examination of lactation and feeding outcomes for preterm infants in the NICU with a biological systems approach to understanding human milk to examine the hypothesis that maternal stress is associated with feeding outcomes and markers of impaired neurodevelopment for preterm infants and alters human milk and infant gut profiles in ways that affect preterm neurodevelopment. The proposed research directly aligns with the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s scientific priorities to reduce the incidence of neurodevelopmental disorders, optimize outcomes for preterm infants by understanding nutrition/feeding and the microbiome, and to understand human milk composition in relationship with maternal characteristics. During the K99 phase, measurement of perceived, biological, and known maternal stressors in the NICU will be conducted and assessed in relation to maternal lactation and feeding outcomes (milk production, mothers’ own milk vs donor milk vs preterm formula) (Aim 1). Infants will also undergo neurodevelopmental testing via electroencephalogram before NICU discharge and at 4 months corrected age to assess the relationship between maternal stress and preterm neurodevelopmental outcomes (Aim 2). Career development activities in the K99 phase, including training in stress physiology and infant neurodevelopment, developing expertise in lactation/feeding outcomes for preterm infants in the NICU, and learning techniques for assessing human milk and infant gut composition data and their interpretation will take place in the excellent research environment at the University of Minnesota School of Public Health Division of Epidemiology and Community Health and will provide the skills needed to successfully examine associations of maternal stress with characteristics of maternal milk and preterm infant gut composition in the R00 phase. Targeted and untargeted metabolic approaches and microbial analyses will be used to elucidate the relationships between human milk and preterm gut composition with maternal stress and preterm neurodevelopmental (Aim 3). The proposed research lays the groundwork for future clinical interventions designed to mitigate the effects of maternal postnatal stress through psychosocial support and/or nutritional supplementation and will also provide foundational data for the successful launch of an independent research career focused on promoting nutritional practices which yield optimal neurodevelopment for preterm infants.

项目概要/摘要 早产和婴儿入住新生儿重症监护病房 (NICU) 的情况都有详细记录 尽管母乳对于促进最佳健康和健康至关重要。 早产儿的神经发育、母亲产后应激对母亲哺乳的影响以及 喂养结果和牛奶成分尚未得到系统检查。该提议的目标。 独立之路奖旨在对哺乳和喂养结果进行详细检查 新生儿重症监护病房 (NICU) 中的早产儿采用生物系统方法了解母乳，以检查 假设母亲的压力与喂养结果和受损标志有关 早产儿的神经发育，并以影响早产儿的方式改变母乳和婴儿肠道特征 拟议的研究与尤尼斯·肯尼迪·施赖弗国家研究所直接相关。 儿童健康和人类发展的科学重点是减少神经发育障碍的发生 通过了解营养/喂养和微生物组来优化早产儿的结局，以及 了解 K99 阶段母乳成分与母体特征的关系。 将在 NICU 中对感知的、生物的和已知的产妇压力源进行测量，并 评估与母亲哺乳和喂养结果的关系（产奶量、母亲自己的奶与捐赠者的奶） 牛奶与早产配方奶粉）（目标 1）。 NICU 出院前和 4 个月校正年龄时的脑电图以评估两者之间的关系 母亲压力与早产神经发育结果之间的关系（目标 2）。 K99阶段，包括应激生理学和婴儿神经发育方面的培训，培养以下方面的专业知识 NICU 中早产儿的哺乳/喂养结果，以及评估母乳的学习技术 婴儿肠道成分数据及其解释将在以下卓越的研究环境中进行 明尼苏达大学公共卫生学院流行病学和社区健康部并将 提供成功检查孕产妇压力与特征的关联所需的技能 R00 阶段的母乳和早产儿肠道成分。 方法和微生物分析将用于阐明母乳和母乳之间的关系 早产儿肠道成分与母体压力和早产儿神经发育的关系（目标 3）。 研究为未来旨在减轻孕产妇影响的临床干预措施奠定了基础 通过心理社会支持和/或营养支持来应对产后压力，还将提供 成功开展专注于促进营养的独立研究事业的基础数据 为早产儿带来最佳神经发育的实践。